Few attempts have been made to directly assess the quality of health care received by hemodialysis patients. The primary objective of this research is to evaluate and compare the quality of care provided to hemodialysis patients who undergo treatment at a facility (either a hospital or free standing unit) and those who self-dialyze at home. Home dialysis represents a form of self-care, while facility dialysis is provider administered. Quality of care is operationalized by measuring five outcome (as opposed to structure or process) categories of variables--restricted activities, medical provider contact, rehabilitation, adjustment, and survival. The independent variable categories are: demographic, pre-existing medical conditions, socioeconomic indicators, locus of control, social support, and dialysis setting. A causal model will be developed and tested, using path analysis, to both explain and predict the outcome quality of care measures. The proposed model is a recursive structural equation model; however, one of the computer programs to be used in the analysis of the data, LISREL III, is fully capable of handling nonrecursive path models (reciprocal causation). It is postulated that the social psychological variables will be of primary importance, not only in the prediction of quality of care outcomes, but also in the patient's selection of dialysis setting (home or facility). Although there are no theories which are explicitly concerned with the quality of health care, it is proposed here that several existing social psychological theories and/or bodies of literature are useful when applied to the assessment of quality of care. Many of these theories are currently being applied in the study of compliance in therapy. The Health Belief Model is a case in point. The data to be used were collected in January and february 1978 by the Research Triangle Institute under contract to the Health Standards and Quality Bureau. The sample, a representative national probability sample, is composed of approximately 500 chronic hemodialysis patients. Both stratification and cluster sampling procedures were employed. Data were obtained from patients, physicians, and the dialysis facilities with which the patients were associated.